Eagerness, anger at NC health coverage deadline

By EMERY P. DALESIO - Associated Press

Published: Monday, March 31, 2014 at 05:41 PM.

RALEIGH — More than a year of effort by a collection of 100-plus North Carolina hospitals, community- and safety-net organizations reached a peak Monday with the deadline for residents to buy private health insurance or face a penalty.

Consumers faced the end-of-March deadline set by the federal health insurance overhaul law. Enrollments in North Carolina already ranked fifth in the country at the end of February, and shopping really picked up in the final week, according to Blue Cross Blue Shield of North Carolina, one of two companies selling policies on a statewide marketplace.

Advocates guided hundreds of people through the details of in-person sign ups at daily events statewide in the final week. Three dozen people waited their turns Monday in the fellowship hall of a Baptist church in Raleigh, ready to consult a computer-equipped guide offering personalized advice on the best coverage deals.

William Leslie, 53, of Raleigh picked up a number and left with plans to return in 1 ½ hours when his turn with a counselor was due to come up. He said he was suddenly shopping for health insurance after losing his warehouse job and health insurance a week ago.

"This is the first time in my life that I have not had a job and been in this predicament. If I had a job, I wouldn't even worry with this," said Leslie, who was looking for coverage just for himself. "I'm not looking for anything that's free or anything. I'm just looking for something that's affordable."

People could comply with the insurance mandate if they are covered by an employer or a government program, of if they buy a policy directly from an insurer. Working through the federal marketplace — North Carolina was one of 36 states that refused to set up its own exchange — was necessary to qualify for subsidies. More than nine out of 10 people who enrolled by March 1, the latest period for which details were available, qualified for subsidies.

But thousands of others missed the deadline. They either didn't know about the requirement to buy health insurance, couldn't afford it despite the subsidies, or rejected being told to buy coverage.

Emily Swindell, her 45-year-old husband and their three sons aged 6 and younger lack coverage, and she said Monday they're making a choice to refuse the sign-up requirement and will accept any resulting penalty later.

"I try not to go to doctors and hospitals unless it's an emergency because I'm 31 years old, I'm relatively healthy. I just don't think it's right that they're forcing people to buy something," said Swindell, a restaurant manager from Denver, N.C.

Swindell said her refusal to buy health insurance has a lot to do with her opposition to abortion — the law guarantees birth control in employees' preventive care plans. But she bridles at the thought that her insurance purchase would somehow subsidize someone else.

Swindell is set to face a penalty of at least $95 this year, but possibly much more. The penalties could reach 1 percent of income if that's higher than $95. So someone earning $45,000 a year could see the Internal Revenue Service collecting about $450.

"I will take the fee," she said. "I haven't even checked into it. I don't even care how much it costs."

North Carolina's reported enrollment so far has outstripped federal projections in advance of October's start of the open enrollment period. Those projections were for 191,000 people to enroll by March 31. By March 1, just over 200,000 people North Carolina residents had selected a health insurance policy, more than half the nearly 391,000 eligible to enroll in a marketplace plan, according to the U.S. Department of Health and Human Services.

Final numbers may not be announced for weeks. Spokesmen for Blue Cross and a division of Aetna, the only other company selling policies on the exchange to North Carolina consumers, declined to describe the scope of their business.

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RALEIGH — More than a year of effort by a collection of 100-plus North Carolina hospitals, community- and safety-net organizations reached a peak Monday with the deadline for residents to buy private health insurance or face a penalty.

Consumers faced the end-of-March deadline set by the federal health insurance overhaul law. Enrollments in North Carolina already ranked fifth in the country at the end of February, and shopping really picked up in the final week, according to Blue Cross Blue Shield of North Carolina, one of two companies selling policies on a statewide marketplace.

Advocates guided hundreds of people through the details of in-person sign ups at daily events statewide in the final week. Three dozen people waited their turns Monday in the fellowship hall of a Baptist church in Raleigh, ready to consult a computer-equipped guide offering personalized advice on the best coverage deals.

William Leslie, 53, of Raleigh picked up a number and left with plans to return in 1 ½ hours when his turn with a counselor was due to come up. He said he was suddenly shopping for health insurance after losing his warehouse job and health insurance a week ago.

"This is the first time in my life that I have not had a job and been in this predicament. If I had a job, I wouldn't even worry with this," said Leslie, who was looking for coverage just for himself. "I'm not looking for anything that's free or anything. I'm just looking for something that's affordable."

People could comply with the insurance mandate if they are covered by an employer or a government program, of if they buy a policy directly from an insurer. Working through the federal marketplace — North Carolina was one of 36 states that refused to set up its own exchange — was necessary to qualify for subsidies. More than nine out of 10 people who enrolled by March 1, the latest period for which details were available, qualified for subsidies.

But thousands of others missed the deadline. They either didn't know about the requirement to buy health insurance, couldn't afford it despite the subsidies, or rejected being told to buy coverage.

Emily Swindell, her 45-year-old husband and their three sons aged 6 and younger lack coverage, and she said Monday they're making a choice to refuse the sign-up requirement and will accept any resulting penalty later.

"I try not to go to doctors and hospitals unless it's an emergency because I'm 31 years old, I'm relatively healthy. I just don't think it's right that they're forcing people to buy something," said Swindell, a restaurant manager from Denver, N.C.

Swindell said her refusal to buy health insurance has a lot to do with her opposition to abortion — the law guarantees birth control in employees' preventive care plans. But she bridles at the thought that her insurance purchase would somehow subsidize someone else.

Swindell is set to face a penalty of at least $95 this year, but possibly much more. The penalties could reach 1 percent of income if that's higher than $95. So someone earning $45,000 a year could see the Internal Revenue Service collecting about $450.

"I will take the fee," she said. "I haven't even checked into it. I don't even care how much it costs."

North Carolina's reported enrollment so far has outstripped federal projections in advance of October's start of the open enrollment period. Those projections were for 191,000 people to enroll by March 31. By March 1, just over 200,000 people North Carolina residents had selected a health insurance policy, more than half the nearly 391,000 eligible to enroll in a marketplace plan, according to the U.S. Department of Health and Human Services.

Final numbers may not be announced for weeks. Spokesmen for Blue Cross and a division of Aetna, the only other company selling policies on the exchange to North Carolina consumers, declined to describe the scope of their business.